IGFBP-4 的 N 端和 C 端片段作为缺血患者发生主要不良心脏事件短期风险评估的新型生物标志物。

N-terminal and C-terminal fragments of IGFBP-4 as novel biomarkers for short-term risk assessment of major adverse cardiac events in patients presenting with ischemia.

机构信息

HyTest Ltd, Intelligate 6th floor, Joukahaisenkatu 6, 20520 Turku, Finland.

出版信息

Clin Biochem. 2012 May;45(7-8):519-24. doi: 10.1016/j.clinbiochem.2011.12.030. Epub 2012 Jan 28.

DOI:10.1016/j.clinbiochem.2011.12.030

PMID:22306170

Abstract

OBJECTIVES

Pregnancy Associated Plasma Protein A (PAPP-A)-derived N- and C-terminal fragments of IGF-binding protein-4 (NT- and CT-IGFBP-4) released from vulnerable atherosclerotic plaques are proposed to be used for cardiovascular risk assessment.

DESIGN AND METHODS

NT- and CT-IGFBP-4 were measured by novel immunoassays in EDTA-plasma of 180 patients admitted to the emergency department with symptoms of myocardial ischemia but without ST-segment elevation. Six-month incidence of major adverse cardiac events (MACE), including myocardial infarction, cardiac death, percutaneous coronary interventions, and coronary artery bypass grafting was recorded.

RESULTS

Sixteen patients met the endpoint. NT- and CT-IGFBP-4 were strong predictors of MACE: area under ROC curve (AUC) 0.856 and 0.809, respectively. NT-IGFBP-4 concentrations≥214μg/L and CT-IGFBP-4 concentrations≥124μg/L were associated with increased risk of future MACE: adjusted hazard ratio 13.79 and 7.93, respectively.

CONCLUSIONS

IGFBP-4 fragments can be utilized as biomarkers for MACE prediction in patients with suspected myocardial ischemia.

摘要

目的

胎盘蛋白 A（PAPP-A）衍生的 IGF 结合蛋白-4（NT-和 CT-IGFBP-4）的 N-和 C-末端片段从易损的动脉粥样硬化斑块中释放出来，被提议用于心血管风险评估。

设计和方法

在因心肌缺血症状而入住急诊室但无 ST 段抬高的 180 名患者的 EDTA 血浆中，使用新型免疫测定法测量 NT-和 CT-IGFBP-4。记录 6 个月时主要不良心脏事件（MACE）的发生率，包括心肌梗死、心脏死亡、经皮冠状动脉介入治疗和冠状动脉旁路移植术。

结果

16 名患者达到终点。NT-和 CT-IGFBP-4 是 MACE 的强预测因子：ROC 曲线下面积（AUC）分别为 0.856 和 0.809。NT-IGFBP-4 浓度≥214μg/L 和 CT-IGFBP-4 浓度≥124μg/L 与未来 MACE 的风险增加相关：调整后的危险比分别为 13.79 和 7.93。